Staying in the labor force among patients with rheumatoid arthritis and associated factors in Southern Brazil

Abstract

Background: Rheumatoid arthritis primarily affects the working-age population and may cause key functional and work limitations. As the disease progresses, individuals become increasingly unable to conduct daily activities, which has a substantial personal and socioeconomic impact. Fairly recent prior studies showed that patients with RA stop working 20 years earlier than age-matched controls. Factors related to sociodemographic, clinical, care and disease profiles might affect the loss of work capacity. The purpose of this study was to assess the factors associated with the prevalence of working patients with rheumatoid arthritis in the municipality of Blumenau. Methods: A cross-sectional, population-based study was conducted between July 2014 and January 2015, with 296 individuals aged 20 years or older, male and female, living in Blumenau, Santa Catarina state, Brazil, and diagnosed with rheumatoid arthritis according to the 1987 American College of Rheumatology criteria. The prevalence of working patients with RA was assessed by employment status self-reporting during the interview. The chi-squared test, Wald test and Poisson regression analysis were used to test the possible associations between the independent variables and outcome. Results: The prevalence of working patients with rheumatoid arthritis was 44.3%. Patients aged 20 to 59 years had a 90% higher prevalence of outcome than subjects aged 60 years or older. The prevalence of working patients was 132% and 73% higher among individuals with low income and high functional disability, measured using the Health Assessment Questionnaire (HAQ), respectively. Conclusion: The prevalence of working RA patients was highest among adult patients with low income and high functional disability. The first variable is directly related to the individual characteristic, the second reflects the socioeconomic context of the patient, and the third reflects the degree of disability caused by the disease, which may be modifiable by health professionals.

Systemic autoimmune diseases and work outcomes in Brazil: a scoping review

“…Azevedo et al 13 observed that 43.2% of their sample of patients with rheumatoid arthritis was working at the time of the interview, and they tended to belong to higher income classes when compared with those who were retired or on sick leave. Conversely, even though the prevalence of working patients with rheumatoid arthritis was similar to that noted by Azevedo et al 13 , in Gomes et al 11 samples, individuals with lower income and greater functional disability remained more frequently in the labor market 11 . The authors hypothesized that these findings might be related to the lack of information on disability retirement, lack of payment of social security contributions, and the need to work to avoid income loss in that rheumatoid arthritis population 11 .…”

“…Most studies were cross-sectional. In six studies, the autoimmune rheumatic disease assessed was rheumatoid arthritis [9][10][11][12][13][14] . The remaining two studies evaluated systemic lupus erythematosus 15,16 .…”

“…None of the eight articles addressed work outcomes in Brazilian patients with systemic sclerosis, Sjögren's syndrome, or idiopathic inflammatory myopathy. Only three studies [10][11][12][13] presented work-related outcomes other than employment statuses, such as work productivity, work impairment, presenteeism, absenteeism, and time on sick leave. None of the studies addressed the theme "return to work".…”

“…Considering the total sample (Brazil and other Latin American countries), higher educational levels were associated with better WLQ-25; previous orthopedic surgeries reduced absenteeism and work limitations; and worsening in disease activity was associated with decreased work productivity. Gomes et al 11…”